PARENT’S CONSENT

I understand that my child/ren’s in-person attendance in school will include associating with teachers,
fellow learners and school personnel, and other persons inside and outside of the school that may put my
child at risk of COVID-19 transmission, notwithstanding the precautions undertaken by the school.
I acknowledge that my child/ren’s participation in this activity is completely voluntary. While there
remains the risk of possible COVID-19 transmission to my child/ren, and to the members of my
household, I freely assume the said risk and I permit my child/ren to attend the end-of-school year
rites.
I am aware that symptoms of COVID-19 include, but are not limited to, fever or chills, cough, shortness
of breath or difficulty in breathing, fatigue, muscle or body aches, headache, loss of taste or smell, sore
throat, congestion or runny nose, nausea, vomiting and diarrhea.
I confirm that my child/ren currently has none of those symptoms and is in good health. I will not allow
my child/ren to physically go to school to attend the end-of-school year rites if my children or any of my
household develops any of the aforementioned symptoms or any other symptoms of illness that may or
may not be related to COVID-19. I will also inform the school and not allow my child/ren to attend the
end-of-school year rites if my child/ren or any of my household members, will follow the required health
and safety protocols and procedures adopted by the school and our community.
To the extent allowed by law and rules, I hereby agree to waive, release, and discharge any of all claims,
causes of action, damages, and rights against the school and its personnel as well as officials and
personnel of the Department of Education relative to the conduct of the activity.
With full understanding, I – on behalf of myself, my household members, and my child/ren – hereby
freely and voluntarily give my consent to my child/ren’s participation in the activity
on______________________. I also attest that I sought the views of my child/ren and he/she has
expressed willingness to participate in the activity.
CONTACT DETAILS FOR QUESTIONS OR PROBLEMS
Signature of Parent/Guardian over Printed Name: Contact Details:

Name of Child/ren: Date: